Posted: 14 Feb 2012 12:50 Post Subject: Balance billing for soft tissue injury
At first you should check the coverage amount for which you have paid the premiums. If it doesn’t cover the full medical bill, then you will have to pay the remainder of the bill out of your pocket. Otherwise contact with the insurance company and ask them about this.
Posted: 14 Feb 2012 01:45 Post Subject: Balance billing for soft tissue injury
If you are covered by Medicare, then balance billing is a fraudulent practice by the insurance company.
Posted: 15 Feb 2012 06:04 Post Subject:
I thought that balance billing was illegal
Your physician is either a "Medicare-approved" provider or he is not. If he is an approved provider, he has agreed to accept Medicare's payment and your 20% coinsurance as payment in full.
If he is not an "approved" provider, he may bill up to 115% of Medicare's allowable charge, and Medicare will pay 80% of the 100% it allows, and the Medicare beneficiary pays an additional 15% of the amount considered the allowable expense.